Emergent, linked traits of fluctuation feedback systems

In this paper, a new design of the model reference control scheme is proposed in a class of nonlinear strict-feedback system. First, the system is analyzed using Lyapunov stability analysis. Next, a model reference is used to improve system performance. Then, the Integral Square Error (ISE) is considered as a cost function to drive the error between the reference model and the system to zero. After that, a powerful metaheuristic optimization method is used to optimize the parameters of the proposed controller. Finally, the results show that the proposed controller can effectively compensate for the strictly-feedback nonlinear system with more desirable performance.

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Clinical dilemmas of routine outcome monitoring and clinical feedback: a qualitative study of patient experiences

10.31234/osf.io/exvyw ◽

2020 ◽

Author(s):

Stig Magne Solstad ◽

Gøril Kleiven Solberg ◽

Louis George Castonguay ◽

Christian Moltu

Keyword(s):

Mental Health ◽

Clinical Skill ◽

Routine Outcome Monitoring ◽

Future Research ◽

Successful Implementation ◽

Basic Training ◽

Feedback Systems ◽

Clinical Encounters ◽

Outcome Monitoring ◽

Clinical Feedback

Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a qualitative, video assisted interview study of 12 patients from a Norwegian mental health outpatient clinic using ROM/CFS. Results: Our analysis resulted in three pairs of opposing experiences with using ROM/CFS: 1) Explicit vs. implicit use of CFS information, 2) CFS directing focus towards- vs. directing focus away from therapeutic topics and 3) Giving vs. receiving feedback. None of these were intrinsically helpful or hindering. Participants had vastly differing preferences for how to use ROM/CFS in clinical encounters, but all needed the information to be used in a meaningful way by their therapists. If not, ROM/CFS was at risk of becoming meaningless and hindering for therapy. Conclusion: These findings confirm and provide further nuance to previous research. We propose to consider ROM/CFS a clinical skill that should be a part of basic training for therapists. How to use and implement ROM/CFS skillfully should also be the focus of future research.

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